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This is an excellent book for people who are more advanced in their aesthetic practice and looking to optimise their toxin results.

The book covers introduction to botulinum toxin and its immunogenicity including neutralising antibodies. The book then discusses combination treatments with botulinum toxins and how results can be optimised with combination treatments including devices, peels, fillers and surgery.

The next section has information with regards to how antibody formation and toxin resistance can occur in some patients. In specific, the 150 kDa neurotoxin block can in fact stop the toxin from binding, clinically giving patients no improvement. It has been shown to be more prevalent in non-aesthetic therapeutic doses than in patients for cosmetic purposes. It then discusses how patients can regain effects if they take a potential ‘treatment holiday’ of at least one to two years, however every individual patient is different and some patients are still non-responders, even when given treatment holidays, so there is no guarantee of response.

The book also covers conversions and calculations when looking at different types of neurotoxins, unwanted side-effects of toxins such as ‘Spock brow’, asymmetry, overdosing or false targeting. The book also covers tips for helping to achieve better results in clinical practice through proper instruments, toxin reconstitution, anatomical considerations and injection depths. There is a real focus on the importance of individualised treatments for our patients through the use of botulinum toxins.

Finally, the book concludes with specific details of how to refine treatments for particular treatment areas; this includes glabellar, forehead and masseters with advise from the literature on eyebrow lifting with toxins and eyebrow reshaping.

For those experienced in their careers, this book makes you rethink your current practices and how these could be enhanced. The book uses a good combination of text and diagrams to help the reader’s learning journey and would be appropriate for doctors, dentists and nurses who are more advanced in their field of cosmetic medicine.

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Amanda Demosthenous

Edinburgh, UK.

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